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Crazy highs and lows

What do late American president Theodore Roosevelt, actress Carrie Fisher and pop star Britney Spears have in common?

They all suffer from bipolar disorder.

This mood disorder is characterised by recurrent bouts of extreme mood changes.

Dr Adrian Wang, a consultant psychiatrist at Dr Adrian Wang Psychiatric And Counselling Care, said: 'It's a brain disorder because it is caused by chemical imbalances.'

While the mood swings make it appear to be psychological, the cause is biological, he said.

Patients veer between two psychological states - mania and melancholia.

When manic, the patient may be in excessively high spirits, is sometimes irritable, needs less sleep with thoughts racing through his brain constantly, talks quickly and makes grand plans.

Symptoms of melancholia are a persistent feeling of sadness, hopelessness and lethargy. He may be unable to eat or sleep.

Dr Ng Beng Yeong, the head of the department of psychiatry at Singapore General Hospital, said: 'In extreme forms (of mania), they may believe they are exceptionally gifted or rich or are important religious, political or famous people.

'The judgment of those with mania is often impaired because of grandiosity and failure to plan or consider the consequences of their actions.'

Mania often requires hospital admission as the manic patient's energy levels may be too much for their family or caregivers to take. The manic patient is also often prone then to excessive or dangerous but pleasurable behaviours like spending too much or sexual indiscretion.

While manic patients invariably sound like they have more fun, Dr Wang noted that depressive lows often last longer than manic highs.

Dr Chua Tze Ern, a registrar in the department of community psychiatry at the Institute of Mental Health, said: 'Different individuals will have different symptoms. One may be predominantly depressed and another may be predominantly manic.'

In between high and low episodes, patients feel well and normal - like everyone else.

The exact cause of bipolar disorder is unknown but doctors believe it is likely to be caused by a plethora of factors interacting with one another.

Dr Ng said: 'It often runs in families and there is a genetic component to the disorder.

'However, even though someone may have inherited the genes for bipolar disorder, there is no guarantee that he will develop it.'

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